T Nation

Starting TRT - Please Take a Look

It takes time to dial in your trt perfectly so that you have no issues with erections. And then even if you feel good may still have erection issues.
So I have erection issues a few days a week. Being I want to perform any day of the week I take Viagra or Cialis. People have been taking these drugs everyday for many years for pulmonary hypertension.
So I think it’s no big deal me taking it.

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Okay. I see no problem either. I probably would do the same when I was in your situation.
I mean, I just wanted to know the reason for it, thought it has something to make with your TRT.

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So it’s nearly my third week of TRT. So far I’m only on TEST Cyp 50mg E3D and HCG 250 UI 2 x a week. Should I start taking AI? I have Symex (Exemestanum) @ home. Or is it better for me to wait until I got the lab results (will do this after the first month, so it will be approx. 7 march)

PS I can do nearly every bloodwork for free, what labs should I take? I’ve been reading here that you guys do not recommend testing free T, instead you are calculating it using SHGB and TT. Is it not necessary to do the free test lab then?

Forget about direct FT labs. Wait for labs indicating high E2.

http://www.issam.ch/freetesto.htm

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I’ll first do the labs yeah. Thanks

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This is how I just woke up. With imprints and redness on my body, I had it on my legs too. Did someone have similar issues?

This is hapenning just now when I restarted TRT. When I was off I didn’t have it like that. Before when I was on TRT I had this too.

I suppose it happens due to higher level of E2 as I am not feeling really well the last couple of days. I have a huge lack of energy, if I only could I’d sleep the whole day long, this is destroying my everyday life.

My first whole month on TRT will be on 7 march 2018 I was going to do the labwork then, but should I do it earlier?

I was willing to wait till then to check if I need some AI (in my case it will be Symex (Exemestanum) as I have it at home) but maybe I should start taking it now? And if yes, what dosage?

Please help me out.

High estrogen? Looks like you are retaining water.

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@KSman I’ve got all the labs you have requested

So I’ve got my levels tested after 1 month of TRT. I am not feeling well - see my last post. I suspect it’s due to high E2 level and progesterone. Please advice. I have Aromasin (Exemestanum) ready to use, only need advice with the dosing.

Testosterone (TTE) 933 165 — 753
Free T 21.5 ng/dL = 2.30 %
(calculated using TTE, SHGB and default albumin 4,3)
Bioavailable Testosterone 504 ng/dL = 54 %
(calculated using TTE, SHGB and default albumin 4,3)

Estradiol (E2) 38,70 pg/ml 11,80 — 39,80
FSH (L65) ↓ < 0,30 mIU/ml 1,40 - 18,10
LH (L67) ↓ < 0,07 mIU/ml 1,50 - 9,30
SHBG (I83) 35,3 nmol/l 14,6 — 94,6
Progesterone 0,166 ng/ml 0,05 — 0,149
PRL 6,3 ng/ml 2,1 — 17,7
Vitamine 25(OH)D Total (O91) 38,50

TSH (L69) 1,309 μIU/ml 0,550 — 4,780
FT3 (O55) 3,81 pg/ml 2,30 — 4,20
FT4 (O69) 1,26 ng/dl 0,89 — 1,76
T3 (O51) 1,77 nmol/l 0,92 — 2,79
T4 (O67) 8,0 μg/dl 4,5 — 10,9
ATG (O18) 18,4 U/ml < 60,0
ATPO < 28,0 U/ml < 60,0

Dehydroepiandrosteron (DHEA) (K25) 12,096 ng/ml
DHEA-S 330,8 μg/dl 34,5 — 568,9
Hemoglobin (HbA1c) (L55) 4,5 %
Hemoglobin (HbA1c) (IFCC) 26 mmol/mol

AST (I19) 30 U/l 10—37
GGTP (L31) 13 U/l <73
Total protein 7,3 g/dl 6,0 - 8,0
Cholesterol total (I99) 143 mg/dl 115-190
Cholesterol HDL w surowicy (K01) 56 mg/dl >40
Triglicerydes (O49) 102 mg/dl <150
Cholesterol LDL - calculated 67 mg/dl
not-HDL 87 mg/dl

B-HCG <0,2 mlU/ml <2,6 (does it mean my HCG works?)

Ferritin 70,5 ng/ml 22—322
PSA total (I61) 1,35 ng/ml <4,00
PSA free (I63) 0,60 ng/ml < 0,72
PSA total/ PSA free 44,44%
ACTH 23,30 pg/ml 7,20 — 63,30

CBC

I have just uploaded my bloodwork.
E2 seems to be in norm, but it is at a high level and I think it can be the cause of all the trouble I am facing right now.

Maybe but I will let others more in the know to chime in regarding your FSH and LH levels. Something’s up.

FSH and LH are blocked, I am using HCG

Ah. Missed that.

You can’t expect miracles after only 1 month on TRT, E2 looks like it is high, but then everyone’s different. I would take .125 AI on each injection day and recheck in a few weeks.

Stop testing FSH and LH while on TRT, pituitary gland is shutdown.

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Of course. I do not expect miracles at all in such a short time as 1 month. But atm I am feeling worse than before the therapy, which is something I didn’t expect at all.
I mean, I am more tired than before, the picture which shows how my body looks after sleeping is also happening after TRT, before it I didn’t had that. It must be something that is going wrong and I don’t understand what it is, I only suspect.

Also what do you exactly mean with .125 AI ? I have Aromasin (Symex) which comes in 25 mg pills.

No one uses Aromasin around here, it’s a suicide AI. Suicidal aromatase inhibitors such as Aromasin (Exemestane) serve to permanently inhibit and disable the aromatase enzyme to which it is bound to[2]. This renders the enzyme inactive forever.

Your expectations are unrealistic, almost everyone goes through a period where they feel terrible for starting TRT. It’s only been a month, we typically “start” to feel good by week 6.

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I guess I’ll need give it some time and test every month.
For now I want to lower E2 a bit so it comes closer to ~22

Is it something else what I can do better?

T shuts down hCG
hCG is not doing that
hCG lab does not confirm that your hCG is good

Testing LH/FSH on TRT is a waste of time+money. However a one time to see that FSH–>zero confirms that there is not a FSH secreting testicular cancer.

Get a home pregnancy test and follow directions. If hCG is good you will be positive. Inject hCG at night and do urine test next morning.

Sleeping creases in skin. Are you also sleeping better and not turning? Try to keep bedding smooth under your body. E2 should be near E2=22pg/ml and your high E2 is probable cause. Take 1/2mg anastrozole at time of injections. Best to try to take things at same time to reduce difficulty.

Labs look good.
Thyroid looks good, no sign of iodine deficiency.
Still need oral body temperatures.

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Misleading: I think that this should not be said at all. You are ignoring the fact that enzymes are turned over rapidly. And when you look at the molecule count of Aromasin weekly dose VS 1mg/week anastrozole there is an obvious problem with what you are saying. Anastrozole is more effective and precisely because it is not enzyme bound it hangs around and does not die with the enzymes as they are turned over and keeps on working.

I have always hated the way that Aromasin is described and hyped.

Okay, I understand, thanks for clearing it out, I’ll do the pregnancy test to see if my HCG works, however my balls are full so I think it is a good sign of the HCG working. Also I’ll test the body temperatures.

I get all my tests for free, I have a private insurance which covers the costs, so I can do as many tests as I want want to, but I’ll stop doing FSH / LH as it is not necessary any more.
Only test I need to pay for is free testosterone, but as far as I understood it is not necessary to test it, because it is better to calculate it, right?

I am currently taking 12,5 mg Aromasin (Symex) E3D, I am taking testosterone and HCG E3D also, so I do them all at once. This tend to work good for me, I feel better and no more sleeping creases and bloated body, so it is E2 causing this issue I think, I still need to do new labs to confirm my new E2 levels, however I feel that the levels are better now.

Can I use 12,5 mg Aromasin E3D instead of Anastrozole? I know it may be better to ask this question after the new labs are coming (I am doing them approx 7 april)
This because of Anastrozole is more expensive for me. However if it is a lot better for me to use Anastrozole I’ll just pay more.

PS I am sweating a lot more since I am on testosterone. Is it normal? Can I do something to reduce the sweating?

Hi guys,

Unfortunately I have no stable access for HCG, so I didn’t had it for a while now. I want to restart HPTA, because of Poland is not ready for TRT yet and I have constantly trouble with getting my drugs etc… also I do not feel quite better while being on TRT.

Suggested HPTA restart claims to use 250 iu HCG EOD for 4-6 weeks, but my balls shrunken of not having it for a while. Can I use some more for the first week? My doc suggests me to restart with 5000 iu for a week x 3, so 15000 iu within 3 weeks. What I wanted to do is inject 5000 iu, then wait a week and after that do 250 iu EOD. Any suggestions?